• Dewa Ayu Puja Satya Dinarta Medhical Laboratory Technology Departement, Health Polytechnic Ministry of Health Surabaya, Indonesia
  • Anik Handayati Medhical Laboratory Technology Departement, Health Polytechnic Ministry of Health Surabaya, Indonesia
  • Syamsul Arifin Medhical Laboratory Technology Departement, Health Polytechnic Ministry of Health Surabaya, Indonesia



Ip Message, peripheral blood smear, platelet histogram, thrombocytopenia


Thrombocytopenia is a condition characterized by low levels of platelets in the blood. The platelet count can be checked using a Hematology analyzer, which is an automatic tool for checking a Complete Blood Count (CBC). The principle of this tool is to detect a signal that is comparable to the cell size that has been set on the tool. The results of the CBC examination are accompanied by a histogram and IP Message if there are abnormal cells, so a confirmatory test using a peripheral blood smear is necessary. The purpose of this study was to determine the suitability of the results of the platelet histogram with the IP Message on the platelet morphology of peripheral blood smears of thrombocytopenia patients. This research is a quantitative descriptive study of 54 samples taken using the Saturation Sampling technique at Grati Pasuruan Hospital using the Sysmex XN-1000 from April 1–30, 2023. The variables in this study are histogram results accompanied by IP Messages and platelet morphology on peripheral blood smears. The results of this study are that the histograms that often appear are abnormal heights on the PU Flag and the IP Messages that often appear are “PLT Clumps?”, with a suitable level of platelet morphology on peripheral blood smear examination reaching 90.7%, so it can be concluded that there is a compatibility between the results of the platelet histogram accompanied by the IP Message on the platelet morphology of the peripheral blood smear of thrombocytopenia patients.


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M. T. Siregar, W. S. Wulan, D. Setiyawan, and A. Nuryati, “Kendali Mutu,” 2018.

Chairani and N. Yani, “Validasi Hasil Pemeriksaan Jumlah Trombosit Secara Autoanalyzer Dan Manual Menggunakan Amonium Oksalat 1%,” Prosiding Seminar Kesehatan Perintis E, vol. 1, no. 1, pp. 2622–2256, 2018.

R. A. Rosyidah, N. Anjani, M. H. Windadari, and A. Mardiyaningsih, “Perbedaan Jumlah Trombosit Pasca Transfusi Thrombocyte Concentrate Dan Thrombocyte Apheresis Pada Pasien Trombositopenia,” Jurnal Kesehatan “Love That Renewed,” vol. Vol.11 No.1, pp. 169–182, 2023, doi:

R. Green and S. Wachsmann-Hogiu, “Development, History, and Future of Automated Cell Counters,” Clinics in Laboratory Medicine, vol. 35, no. 1. W.B. Saunders, pp. 1–10, Mar. 01, 2015. doi: 10.1016/j.cll.2014.11.003.

N. Patro, A. Buch, M. Naik, S. Vimal, and S. Chandanwale, “Assessment and Reliability of Suspect Flags in Automated Hematology Analyzers for Diagnosing White Blood Cell and Platelet Disorders,” Medical Journal of Dr. D.Y. Patil Vidyapeeth, pp. 667–671, 2020, doi: 10.4103/mjdrdypu.mjdrdypu_46_20.

A. Ortiz and J. Demarco, “Performance Comparison of Sysmex Hematology Analyzers XN-550 and XN-10,” vol. 30, no. 1, 2020.

Sysmex Corporation, “Automated Hematology Analyzer XN Series (XN-1000) Instructions for Use,” 2021.

M. Sassi, W. Dibej, B. Abdi, F. Abderrazak, M. Hassine, and H. Babba, “Performances Diagnostiques Des Anomalies Graphiques Dans La Détection Des Macroplaquettes Et Des Agrégats Plaquettaires,” Pathologie Biologie, vol. 63, no. 6, pp. 248–251, Dec. 2015, doi: 10.1016/j.patbio.2015.09.003.

R. Bhadran, S. S. Mathew, A. J, and B. Jayalekshmi, “A Study on RBC Histogram In Different Morphological Types of Anemia In Comparison With Peripheral Blood Smears in A Tertiary Care Centre In Rural South india,” International Journal of Applied Research, vol. 6, no. 10, pp. 425–430, 2020.

Nikhil, S. Das, and R. Kalyani, “Comparative Assessment of WBC Scattergram, Histogram and Platelet Indices in COVID-19 and Non COVID-19 Patients: A Cross-sectional Study,” JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022, doi: 10.7860/jcdr/2022/56018.16794.

E. T. A. Thomas, B. S, and A. Majeed, “Clinical Utility of Blood Cell Histogram Interpretation,” Journal of Clinical Diagnostic Research, vol. 11, no. 9, Sep. 2017, Accessed: Nov. 28, 2022. [Online]. Available:

K. Hummel, M. Sachse, J. J. M. L. Hoffmann, and L. P. J. M. van Dun, “Comparative Evaluation of Platelet Counts in Two Hematology Analyzers and Potential Effects on Prophylactic Platelet Transfusion Decisions,” Transfusion (Paris), vol. 58, no. 10, pp. 2301–2308, Oct. 2018, doi: 10.1111/trf.14886.

U. Ani and M. S. Aulya, “Perbedaan Jumlah Trombosit Metode Automatic Dan Metode Tak Langsung,” AGUSTUS, no. 1, 2016.

C. Briggs and S. J. Machin, Automated Platelet Analysis, 1st ed. London: Blackwell Publishing Ltd, 2012.

J. Deng et al., “Mindray SF-Cube Technology: An Effective Way for Correcting Platelet Count in Individuals with EDTA Dependent Pseudo Thrombocytopenia,” Clinica Chimica Acta, vol. 502, pp. 99–101, Mar. 2020, doi: 10.1016/j.cca.2019.12.012.

A. Gupta, P. Gupta, and B. V M, “Interpretation of Histograms and Its Correlation with Peripheral Smear Findings,” J Evol Med Dent Sci, vol. 6, no. 60, pp. 4417–4420, Jul. 2017, doi: 10.14260/jemds/2017/955.

B. H. Davis and P. W. Barnes, Automated Cell Analysis: Principle in: Laboratory Hematology Practice, 1st ed. UK: Blackwell Publishing Ltd, 2012. Accessed: May 22, 2023. [Online]. Available:

J. Y. Seo, S. T. Lee, and S. H. Kim, “Performance Evaluation of The New Hematology Analyzer Sysmex XN-series,” Int J Lab Hematol, vol. 37, no. 2, pp. 155–164, Apr. 2015, doi: 10.1111/ijlh.12254.

Sysmex, “XN-Serie Flagging-Guide (DE),” Deutschland, Feb. 2019. [Online]. Available:

A. Martinez-Iribarren, X. Tejedor, À. S. Sanjaume, A. Leis, M. D. Botias, and C. Morales-Indiano, “The New UniCel DxH 900 Coulter Cellular Analysis System,” Int J Lab Hematol, vol. 43, no. 4, pp. 623–631, 2021, doi:

Ó. Fuster, B. Andino, and B. Laiz, “Performance evaluation of low platelet count and platelet clumps detection on Mindray BC-6800 hematology analyzer,” Clinical Chemistry and Laboratory Medicine, vol. 54, no. 2. Walter de Gruyter GmbH, pp. e49–e51, Feb. 01, 2016. doi: 10.1515/cclm-2015-0409.

P. Xu et al., “The Flagging Features of the Sysmex XN-10 Analyser for Detecting Platelet Clumps and The Impacts of Platelet Clumps on Complete Blood Count Parameters,” Clinical Chemistry and Laboratory Medicine (CCLM), vol. 60, no. 5, pp. 748–755, 2022, doi:

M. Gioia et al., “Multicenter Evaluation of Analytical Performances of Platelet Counts and Platelet Parameters: Carryover, Precision, and Stability,” Int J Lab Hematol, vol. 42, no. 5, pp. 552–564, Oct. 2020, doi: 10.1111/ijlh.13204.

V. Baccini et al., “Platelet Counting: Ugly Traps and Good Advice. Proposals From the French-Speaking Cellular Hematology Group (GFHC),” Journal of Clinical Medicine, vol. 9, no. 3. MDPI, Mar. 01, 2020. doi: 10.3390/jcm9030808.

V. Křížková, Blood and Blood Components: hematopoiesis, selected methods used in cytology, histology, and hematology. Praha: Universitas Charles, 2021.

Q. Dai et al., “Two Cases of False Platelet Clumps Flagged by The Automated Hematology Analyzer Sysmex XE-2100,” Clinica Chimica Acta, vol. 429, pp. 152–156, Feb. 2014, doi: 10.1016/j.cca.2013.12.013.

A. V. Grob and A. Angelillo-Scherrer, “Leukoagglutination Reported ss Platelet Clumps,” Blood, vol. 118, no. 11, p. 2940, Sep. 2011, doi: 10.1182/blood-2010-09-306266.

J. Hawkins, G. Gulati, G. Uppal, and J. Gong, “Assessment of the Reliability of the Sysmex XE-5000 Analyzer to Detect Platelet Clumps,” Lab Med, vol. 47, no. 3, pp. 189–194, Aug. 2016, doi: 10.1093/labmed/lmw016.

C. Tantanate, L. Khowawisetsut, and K. Pattanapanyasat, “Performance Evaluation of Automated Impedance and Optical Fluorescence Platelet Counts Compared with International Reference Method in Patients with Thalassemia,” Arch Pathol Lab Med, vol. 141, no. 6, pp. 830–836, Jun. 2017, doi: 10.5858/arpa.2016-0222-OA.

M. R. Boulassel, R. Al-Farsi, S. Al-Hashmi, H. Al-Riyami, H. Khan, and S. Al-Kindi, “Accuracy of Platelet Counting by Optical and Impedance Methods in Patients with Thrombocytopaenia and Microcytosis,” Sultan Qaboos Univ Med J, vol. 15, no. 4, pp. e463–e468, Nov. 2015, doi: 10.18295/squmj.2015.15.04.004.

Bavani S, E. Ni, and Reezal I, “Influence of Red Cell Microcytosis in the Accuracy of Platelet Counting by Automated Methods,” Journal of Pharmaceutical Sciences and Research, vol. 11, no. 4, pp. 1506–1509, 2019.

L. L. Pan, C. M. Chen, W. T. Huang, and C. K. Sun, “Enhanced Accuracy of Optical Platelet Counts in Microcytic Anemia,” Lab Medicine, vol. 45, no. 1, pp. 32–36, Dec. 2014, doi: 10.1309/LM7QPULDM5IHBO3L




How to Cite

Dewa Ayu Puja Satya Dinarta, Anik Handayati, and Syamsul Arifin, “The COMPATIBILITY BETWEEN PLATELET HISTOGRAM WITH IP MESSAGE AND PLATELET MORPHOLOGY IN THROMBOCYTOPENIA PATIENTS”, International Journal of Advanced Health Science and Technology, vol. 3, no. 6, Dec. 2023.



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